Here are some reasons why SSS maternity benefit claims are denied
These are based on the personal experiences of women SSS members who have commented on our blogs.
1. Member is not eligible for maternity benefit.
Member has not paid her contributions for at least 3 of the 12 months BEFORE semester of delivery or semester of contingency.
2. Applicable Contributions are Paid, but Not yet Remitted by Employer or Not Yet Posted
If you're Employed, before you file your maternity claim, make sure that the 6 monthly contributions that will be considered by SSS in computing your Maternity Benefit are already posted in your SSS account. Check your online SSS account.
3. Birth Certificate of Child was not Authenticated by the local registrar or PSA (formerly NSO).
Do not submit the birth certificate issued by the hospital. Get your child's birth certificate from the Philippine Statistics Authority (PSA, formerly NSO), or get a Certified True Copy of your child's birth certificate from your Local Civil Registrar.
4. Signature in MAT1 is different from Signature in MAT2 because in MAT1, the maiden name is used, and in MAT2, the married name is used, and that SSS has not yet been updated about the change in civil status using the SSS Member Data Change Request E-4 form.
If you want to change your surname as you are processing your claim, it is best to first wait that the change in surname is effected before you submit your MAT2 claim. Check your online SSS account from time to time.
MAT1 = Maternity Notification
MAT2 = Maternity Benefit Application for Self-Employed, Voluntary
or Separated Members
or
Maternity Benefit Reimbursement for Employed Members
5. Your Coverage Status in your Record is Different from your Status in your Claim
Example: You checked VOLUNTARY in your MAT2 form, but your status in your SSS account is EMPLOYED.
6. Questions about the Child's Middle Name and Surname
Example: The child's middle name is different from the mother's surname, and the child's surname is different from the father's surname.
Remedy for this: Submit Affidavit to Explain Discrepancy in Names
7. MAT1 was not submitted to SSS before delivery of the child. Or maternity notification was not filed online before date of delivery.
If you were not able to submit MAT1 or notify SSS online before delivering your child, attach your letter of explanation to your MAT1 form and ultrasound report or pregnancy test report.
Not all explanations are accepted; it depends on your reason and on the SSS officer evaluating your claim.
8. Member delivered her child by CS, but did not submit Operating Room Record
9. Member had Miscarriage, but did not submit Histopathology Report and Medical Certificate
10. Member had ultrasound before Miscarriage, but Ultrasound does not show any proof of pregnancy, and OB-Gyne did not certify there was pregnancy.
Alam mo or na-feel mo na naging pregnant ka (kaya ka nga nakunan), kaya lang hindi makita ng SSS ang proof na naging pregnant ka.
Usually, ang mga cases na ganito ay yong nakukunan ng days pa lang up to around 7 weeks pa lang ang pregnancy. Akala pa ng iba ay delayed menstruation lang. Itong cases usually ang mahirap i-prove ang pregnancy, kasi walang prior ultrasound or walang makita sa ultrasound.
Kaya doon sa Maternity Notification, nakalagay doon na ang earliest na puedeng mag-submit ng notification sa SSS ay sa 60th day after conception.
11. Member recently resigned from work, but did not submit these 3 documents:
Certificate of Separation
Certificate of Non-Advancement of Maternity Benefit
L-501 form
If your date of separation from employment is within 6 months of your date of delivery, you need to submit these 3 documents from your former employer:
. Certificate of Separation from Employment (must include date of separation)
. Certificate of Non-Advancement of Maternity Benefit (this means your employer did not advance any amount of maternity benefit to you)
. 2 copies of Specimen Signature Card (SSS Form L-501)
If the gap between your Date of Separation and Date of Delivery is more than 6 months, but less than 1 year, prepare to submit these 3 documents. The rule mentions 6 months, but there are officers still requiring these documents even if the gap is more than 6 months.
There was one member who commented here, saying that the gap in her case is 11 months and 28 days, and her claim papers were accepted. But later on, her claim was Denied due to lack of separation papers. She had to wait for her rejected papers, and had to resubmit her claim.
Hindi mo na ba makita ang employer mo? Or nag-AWOL ka ba?
If you can no longer find your former employer, or if you went AWOL and your request for documents is not attended to, you can use this form: Affidavit of Undertaking (English) or
Affidavit of Undertaking (Tagalog) or Affidavit of Undertaking (Visayan).
12. There's an error in the Certificate of Separation or L-501.
Example: The signatures on the L-501 and Certificate of Separation are not the same. Or there is No Date of Separation in the Certificate of Separation.
13. It was Certificate of Employment that was submitted.
Submit Certificate of Separation. These 2 kinds of certificates have almost the same contents, but they have different emphasis. There have been at least 3 members whose claims were Denied because of this reason.
14. The Numbers of Pregnancies or Deliveries or Miscarriages in the Forms or in Previous Maternity Claims are not consistent.
Example: In your MAT1 form, you wrote 2nd pregnancy, but the Birth Certificate shows 3rd in Birth Order. Another Example: 3rd pregnancy in MAT1, but MAT2 shows 2 miscarriages and 2 deliveries or the Birth Certificate shows 4 in Total No. of Children Born Alive.
15. Member has no Date of Coverage.
Usually, a member discovers that she has no Date of Coverage upon submission of MAT1, but there are cases that are not detected early, especially now that MAT1 can be submitted online.
Why are there members without Date of Coverage (DOC)?
These members without DOC are usually the ones who have been paying their contributions as Voluntary without first registering properly and correctly.
You have a Date of Coverage if:
. you were reported to SSS by your employer as Employee
. you registered at an SSS branch as Self-Employed using RS1 form and your Proof of Source of Income and your application was approved
. you registered as Non-Working Spouse and your application was approved
. you registered as OFW and your application was approved
Making your FIRST payment to SSS as Voluntary is not allowed. You become Voluntary only when you stop being an Employee, Non-Working Spouse, Self-Employed or OFW, and you decide to continue making SSS contributions.
16. Your Employer Has Not Filed Its Sickness and Maternity Benefits Payment Thru the Bank (SMB) form
SSS now requires every employer to file its SMB PB form. SSS will pay your maternity benefit through the SSS-registered bank account of your employer. If you're Employed, ask your employer if it has filed its SMB PB form before filing your maternity benefit claim.
17. Hindi na ito -->> 5th or Subsequent Pregnancy or Miscarriage
Salamat at hindi na rason ito under the New Maternity Leave Law.
Dati, merong ganitong rule: Only the first four deliveries or miscarriages are covered under the SSS maternity benefit program. This policy started on May 24, 1997. Even if you were not able to claim your maternity benefit for your first four deliveries or miscarriages, you can no longer claim for your 5th or subsequent deliveries or miscarriages.
Under the new law, UNLIMITED na. Kahit ilang pregnancies or miscarriages, covered na lahat.
UPDATE:
Since June 2016, there have been already a separate application form for those EMPLOYED and those NOT EMPLOYED:
Maternity Benefit Application Form for Self-Employed, Voluntary Member and OFW
Maternity Benefit Reimbursement Form for Employed Member
Related posts:
No. of Pregnancies or Deliveries or Miscarriages in Your SSS Maternity Benefit Claim
documents should be consistent
What to Do When Your SSS Maternity Benefit Is Denied
You might like to learn some interesting things from Previous Comments from Users: Reasons Why SSS Maternity Benefit Claims Are Denied
Comments from July 12, 2013 to May 28, 2014
Comments from
Photo Credit for Photo of Pregnant Woman Above:
Image by Fernando Zamora from Pixabay
This post on Reasons for SSS Maternity Benefit Rejection has received more than a thousand comments over the years, so I had to move the comments to Google Drive and to another post.
If you like, you can go to the links above to see these comments.Here below are some of the most helpful or interesting comments:
From Unknown 10/6/17:
Hello! Just to share my experience, I got pregnant August 2014 and went AWOL January 2015 from my employer. Mula noon nagvoluntary member ako sa SSS and filed my maternity notification. Upon filing nakita ko sa requirements na kailangan ko ng Certificate of Separation, Certificate of Non-Advancement of Maternity Benefit and L-501 form. It was impossible for me na makuha yung mga documents dahil sa status ko na AWOL so hindi na ako nag-abala na magpasa ng MAT-2 after ko manganak ng May 2015. Pero, recently upon searching sa internet I learned na pwede palang gumamit ng AFFIDAVIT OF UNDERTAKING for cases like mine na hindi makakuha ng documents from past employer dahil ng AWOL status ko. It just cost me 100 pesos para ipanotarize yung affidavit together with all other requirements for Voluntary/Separated member CS delivery such as Certified True copy Operating Room Record, Discharge Summary, Clinical History, ipinasa ko na lahat ng pwede just to assure na hindi madedeny yung application ko and luckily after 3 weeks of waiting when I checked my maternity benefit claim status sa sss website, it was already SETTLED and as of now I am waiting na mareflect na sa account ko yung maternity benefit ko.
From Michelle 10/1/17:
Hi po...nakunan po ako nung september 20..10 weeks pregnant po ako nun..na raspa po ako... kaya lang po hindi po ako nakapag pasa ng MAT1 at wala din po akong ultrasound before ako makunan.. pwede pa po kaya ako makakuha ng maternity? Thank you po sa pag sagot.
From Unknown in reply to Michelle above 10/12/17:
Same tayo michelle. Mat 2 nlng po i file nyo sa sss.. Yan din ung sinabi ng sss sakin.. Need lang ng ultrasound before and after ka nakunan yan ung requirements nila
From shania 4/24/17:
HI MS KD, Patulong naman. ito reply sakin ng previous Company ko. Wala talaga akong natanggap na any amount. online-accepted status ko sa sss website. Rule ng Company, hindi pwedeng mag walk in sa kanila previous employee. May portal/website sila for us. Please enlighten me sa dapat gawin. Its been 3yrs. Im lacking L501. Di kasi nila maprovide.
Upon carefully checking our records, we have seen that you were able to receive your Mat-1 claim Cash Advance. However, the cash advance was not deducted from your final pay. Thus, we cannot provide a certificate of Non cash advance, as well as the L501 form and your Maternity documents. We can offer you two options for that, one is that you can submit the lacking documents for your Mat-2 claim so that we can process the reimbursement of the Maternity claim. We will then notify you once we receive the reimbursement so that you can claim the second half of your Maternity claim. The second option is to provide an Authority to deduct form for us to be able to deduct the Mat-1 claim from your final pay for us to be able to process the requested Certificate of Non Cash Advance.
Kindly let us know your decision by creating another ticket.
KD 4/24/17: Hi shania: Ano yong option 2 nila? Hindi mo pa ba nakukuha ang final pay mo from them? Or ang ibig nilang sabihin ay isoli mo yong inadvance nila na one-half? If you don't remember any cash advance, ask them through their portal if they gave you your cash advance through payroll (payslip) or through a check.
Kung hindi pa nabigay ang final pay mo, I suggest choose their option 2, so you can file your own claim directly with SSS
Hi KD. thanks for replying.
Bale. 8k lang nakuha ko thru atm. Backpay ko yun. Yung mat ko is 33k yung approved amount approved ng SSS. So kung first half nakuha ko roughly 15k sana. Nasakin lahat ng MAT2 FORMS. Diko binigay sa kanila kasi nga theyre saying na nag cash advance daw ako. Wala ako nareceive. And separated status ko. I resigned AUG then DEC 2014 ako manganak. Wala talaga sila maadvance.
I secured L501, CERT OF NON ADVANCEMENT, AND CERT OF SEPARATION FROM EMPLOYER bago ako magresign. Yung HR admin pinirmahan yung 2 except L501.
So dinala ko sya sa SSS. Sabi ng SSS meron lang daw mga tao from my company na dapat pumirma dun hindi ang Hr na yun. Pagbalik ko, since separated employee nako. Nirefer ako sa portal. Tho andun yung mga tao na dapat pipirma. Hindi po gumagana ang portal nila. Never gumana. Im losing hope na talaga.
ilang beses nako bumalik. Wala naman sila mapresent sakin na documentation na nag cash advance ako. And wala akong any check or anything na pinirmahan sa kanila. Gusto ko nalang magfile ng complaint talaga. :(
Leesa 3/29/17:
Good day! Tanong ko lang po sana kung anung pwede kong gawin.naghulog po ako sa sss ko as voluntary nung march 2016 tapos po employed po ako from june 2016 to august 2016 pero po ang naipost lang na contribution ng employer ko ay july 2016. Pinapaayos ko po sa employer ko yung contribution ko for the month of june, april 2017 po yung expected due date ko. Tanung ko lang po sana kung kapag naipost na po ba yung contribution ko ng june e pwede ba akong magclaim ng maternity benefits? Salamat po
Unknown in reply to Leesa: 3/29/17
Ang alam ko kasi mas maganda sana kun jan2016 to dec2016 ka naghulog para sure na may makuha ka kasi ako completo un last year ko due date ko ngayun june2017 nag inquire ako sa may online sss nakita ko na eligibility ako pwedi ako makakuha ng maternity dahil sa contribute ko ..ask mo rin sa sss kun kaylangan mo pa maghulog para hangat di kapa nanga2nak maasikaso muna para makakuha ka ng maternity
Leesa 3/29/17:
Last time kasi na naginquire ako sa sss sabi saken basta daw maipost yung contribution ko ng month of june makakakuha daw ako ng maternity benefits. Kaso ang probkema ko lang is 'til now di pa naaayos ng employer ko yung contribution ko. Anytime kasi pwede na kong manganak pero di pa rin ako nakakapagpasa ng mat1 baka kasi di na pwedeng ayusin yun pag nanganak na sayang naman.
Unknown in reply to Leesa 3/29/17:
Lakarin mo muna agad yung mat 1 mo ..ako last year ko pa nalakad ..tapos pag wala pa rin hulog ng june 2016 mo tanung mo kung pwedi ikaw na lang maghulog sayang kasi..
Self-employed at voluntary lang ang diretso ang maternity or sickness benefit.
ng March
Jan 2019- 1760
Feb2019- 1760
March2019-1760
April2019-2400
May2019-2400
June2019- 0
July2019-0
August2019-480
Sept2019- 2400
Oct2019-2400
Nov2019-2400
Dec2019-2400
Jan2020-2400
Feb2020-2400
March2020-2400
Sa mga naihulog ko po na qualified po ba ako sa maximum benefit na 70k? Thank you in advance
NO CERTIFICATE OF SEPARATION FROM EMPLOYMENT ISSUED AND DULY SIGNED BY LAST EMPLOYER'S AUTHORIZED SIGNATORY PRIOR TO APPLIED CONFINEMENT PERIOD ano po ba ibig sabihin po nyan at paano ko po maaayos para maging ok na po kelangan ko po kase talaga yung maternity ko po maraming salamat po sa sasagot
Kung hindi nagbabago yong "Denied" sa portal mo, magpa-appointment ka uli sa branch mo para tanungin kasi nag-submit ka naman. Bring your photocopies. Magpa-photo-copy ka pa uli ng para sa iyo para may hawak ka.
Ask ko lng po. Separated po aq sa work last april 2019 pero before po ako umalis naka file po ung mat1 ko sa company. I gave birth dec 2019 need ko pa rin po ba ng non advancement at L501.. Pano po un employed na po ako sa bagong company ngaun starting march2020. Pde pa po ba ako mg file ng mat2 personally or company na po? Saan po papasok un matben ko if ever maapproved po ako..
Thank you po
Ang 12mos ko ay october 2018 to sept 2019. Nagbayad po ako mg pang july ay october na kasi sabi po ng teller pwede pa july to sept na sana dapat ay october ang huhulugan ko. Napanood ko na po ang mga vlog tungkol sa denied matben at magbasa basa din. Pero wala po akong napanood o nabasa na ganon ang dahilan.
If yes, dapat meron ka pa ring benefit, half of your benefit kung 3 months lang ang nabayaran mo within Oct 2018 to June.
Kindly tell me muna ang month of delivery mo at mga months na binayaran mo within the 12 months prior to semester of contingency at kung kelan mo binayaran para ma-complete ko ang sagot. Merong rule ang SSS na hindi ma-consider ang contributions na binayaran within semester of contingency.
Yung mat 1 ko pa thru online ko lang pinasa magagawan pa po ba yun ng paraan? Para ma approve?
Wla din akong natangap na cashadvance..
Ibig mo bang sabihin ay na-submit mo na yong Affidavit of Undertaking, pero rejected pa rin?
Kung sakaling makukuha ko pa, gaano po ba katagal aantayin ko ulit para makuha ko na po MAT claim ko? Salamat po
Sabi ng SSS, around one month ang waiting time for corrected claims. Puedeng mas matagal pa.
Claim is for adjustment / initial claim for re-bacth
Sana po mapansin salamat
Claim is for adjustment / initial claim for re-bacth
Sana po mapansin salamat
Ano po ibig sabhin nyan nd n po b ako pwede maclaim at makricieve ng maternity benefits ko or ano po gagawin ko pakisagot amn po, sana po mapansin concern ko salamat po ng marami godbless us
Meron ding rule ang SSS na kapag less than 6 months ang gap ng date of separation and date of delivery, Separated ang temporary status at required ang certificate of separation, cert of non-payment of maternity benefits and L-501 form (yong ibang branch hindi strict sa L-501 form). Merong ding officer na kahit 7 or 8 months na ang gap, nire-require pa rin ang additional docs from former employer (merong mga nag-comment dito dati).
1 to g4 normal delivery c g5 misscarge at remark na yung pang 6th ko. Pero nakalagy sa sss ko rejected discrepancy in the pregnancy number being filed maayus o saan po ba ang may mali? Si misscarge po dugo plang sya nang nakunan ako.ano po ba dapat gawin para nd na ma reject matben ko.pls po pa help stress na ko dito..
Doon sa Maternity Notification mo, sana ganito ang sagot mo:
a. This is my 6th pregnancy and my expected date of delivery is on _____
b. Prior to this notification, I have 4 deliveries and 1 miscarriage
Doon sa Maternity Benefit Reimbursement Application (use this form kasi employee ka), sana ganito ang sagot mo:
Number of Pregnancies: 6
Doon sa Obstetrical History: Mula G1 hanggang G4, write dates of birth and write normal delivery if normal, Cesarean Section if Cesarean. Doon sa G5, write date of miscarriage, and type of delivery is Miscarriage. Yong G6, date of birth and type of delivery is normal delivery.
Kapag naisoli na sa yo yong denied documents, puede ka nang mag-refile.
Tama naman na 5 kids lang ang nasa Birth Certificate ng pang-6th mong baby kasi ang tanong is Total Number of Children Born Alive: 5
Total Number of Children still Living Including this birth: 5
No. of children born alive but are now dead: 0
Hindi kasali ang miscarriage sa Certificate of Live Birth, kasi wala namang tanong na number of pregnancies or number of miscarriages, puro tanong about live births.